高纯HMG和普通HMG与rFSH联用的IVF-ET妊娠结局比较

Effectiveness of highly purified HMG versus ordinary HMG with rFSH on pregnancy outcomes in IVF

目的比较体外受精-胚胎移植(IVF-ET)周期中应用高纯度人绝经期促性腺激素(HP-HMG)和普通HMG分别与rFSH联用进行超促排卵的妊娠结局。方法采用前瞻性研究方法,选择符合条件的300例不育妇女,按照随机数字表进行分组后进行IVF-ET治疗。高纯HMG组(150例)使用高纯HMG与rFSH;普通HMG组(150例)使用普通HMG与rFSH。比较两组患者促排卵后的临床指标:正常受精率、优胚数、囊胚形成率、种植率、妊娠率、早期流产率。结果高纯HMG组HCG日的FSH值[(12.25±3.83)U/L]、Gn用量[(1 737.34±464.41)U]和Gn刺激天数[(9.51±1.36)d]均显著低于普通HMG组[分别为(14.36±4.83)U/L、(1 881.53±495.36)U和(9.85±1.59)d](P均<0.05)。高纯HMG组的囊胚形成率(66.41%)、种植率(56.21%)、生化妊娠率(78.89%)及临床妊娠率(70.00%)均显著高于普通HMG组(分别为60.66%、41.94%、63.21%、58.49%)(P均<0.05)。两组患者的获卵数、正常受精率、优胚数、移植胚胎数及早期流产率比较均无显著性差异(P>0.05)。结论 IVF周期中应用高纯HMG促排卵可以降低Gn用量、减少Gn用药天数,且能明显改善妊娠结局。

Objective： To compare the effectiveness of highly purified HMG and ordinary HMG with rFSH on pregnancy outcomes in IVF.Methods： A total of 300 women undergoing IVF-ET were allocated randomly to either rFSH＋HMG group（n=150）or rFSH＋HP-HMG group（n=150）for ovarian stimulation.Clinical outcomes including2 PN rate,number of good quality embryos,blastulation rate,implantation rate,pregnancy rate and trimester miscarriage rate after ovarian stimulation were compared between the two groups.Results： The FSH levels on HCG day [（12.25±3.83）vs.（14.36±4.83）U/L],total dose of gonadotropin（Gn）used [（1 737.34±464.4）vs.（1 881.53±495.36）U]and the stimulation duration[（9.51±1.36）vs.（9.85±1.59）days]were significantly lower in the HP-HMG group than those in the ordinary HMG group（all P〈0.05）.The blastulation rate（66.41% vs.60.66%）,implantation rate（56.21% vs.41.94%）,biochemical pregnancy rate（78.89% vs.63.21%）and clinical pregnancy rate（70.00% vs.58.49%）in the HP-HMG group were significantly higher than those in the ordinary HMG group（P〈0.05）.No significant differences in the number of oocytes retrieved,2PN rate,number of good quality embryos,number of embryos transfer,first trimester miscarriage rate were found between the ordinary HMG and highly purified HMG group（P〉0.05）.Conclusions： Application of highly purified HMG in IVF cycle can decrease the total dose of Gn used and stimulation duration,and significantly improve pregnancy outcomes in IVF-ET.